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Healthcare and LGBTQIA+ Community - Dr. Ciara Greer (Co-Chair of GLADD: the Association of LGBTQ+ Doctors and Dentists)

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Summary

This on-demand teaching session is a deep dive into the history of medicalization of LGBTQ identities, discussing influential figures and policies in terms of criminalizing and curing homosexuality, treatment of trans individuals, and politics around gender identification. Learn about the history of medicalization from the late 19th to early 21st century and understand the complexities of protecting vulnerable individuals in the medical profession while remaining true to medicalization ethics.

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Learning objectives

Learning Objectives:

  1. Understand the changing historical perspective of medicalization of LGBT identities.
  2. Become aware of the dangerous practices in the past and laws in the present to treat LGBT individuals.
  3. Understand to the dangers of so called conversion therapies, and the best way to support potential victims now.
  4. Understand the debate around whether transgender people should have access to women-only spaces.
  5. Be aware of the small proportion of people in the medical profession who were supportive of LGBT individuals in the past.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Okay, Senate Eso I mean, my screen. It looks like we've got a lot of, um Jennifer. Um, but would that be other people? We could maybe give it a couple more minutes, I think. No, that's not mean. I don't mind if it's just maybe trying to Jennifer, I It's just like if, ah, I don't want to be ignoring if there's other people who will somehow watching magically, not from this room. Them, like, you know, with your self interest. Yeah, um, maybe if you feel I just million, I'm personally take a literate. So, like, using things like this, and I was like, Fine, you don't You don't have to make excuses. I think it's always very hard when you're you've got multiple events. Because, like, one of them is always gonna be more interesting than the other. So and I got a mind. Um, well, a some there's on the mouth has joined us. Okay, I'm just gonna kind of took away, because I know, uh, my name's Karen, uh, pronounce she and her. I'm in the association of LGBTQ class doctors and dentists. Bit of a mouthful, but we go by Glad, uh, cause years ago. The original name was the gay and Lesbian. A soft association of doctors and dentists. So, um but we, um you know, obviously over the years or 25 years ish 96. Now, since we, as an organization have been established, have, obviously, you know, sort of brought him to try to keep up today with the needs of the LGBT. Keep us community and, you know, dentists within or doctors as well within on the students, respectively. I I did it all recently about the sort of history of medicalization on per follows up. Pathology is a shin off GGT events identities. I'm going to say LGBT just because it's slightly less of a mouthful. But like in general, if I say that I do generally mean the whole sort of rainbow community and anybody that you know would be a part of that, um, Andi is, you know, it's really interesting the way that medicines relationship to G B T identities have has changed over the last couple 100 years coming. Um, people that look into quit teary as it's sort of known in, um, you know, university or research circles. Whatever he would tell you that, like gay, has only been a thing of flick in the last 450 ish years. Like before. You know, being being homosexual wasn't an identity. It wasn't a part of that who you were. It was somebody the commit a crime in the same way that like if you stole something, you were a thief. But it wasn't like you were a safe forever. Like I wasn't part of who you were. You were just this person that did some weird gross stuff in some cases. So gross or you know where that you could be in present or killed for it. You know, it wasn't until the 18 hundreds that they, you know, D death penalty. Um, sort of makes, you know, on a nail sex, uh, specifically between men. Really, But and there's been sort of some injury, you know, since the psychiatric development off a psychiatry, You know, in the late 19th century, you know, there was this increasing, like idea that people had mental mental health problems which could be fixed in the same way that health problems could be fixed on. They started to see at that point that, like deviants well, conversion are being gay. It was a part of the labs. There was quite a long period of time at which we tried to treat being gay with a variety of different stuff. And there's a lot of different theories based on it. You know, Freud was actually fairly open minded about homosexuality compared to a lot of contemporaries, but still thought that it was, I think now I could be slightly wrong. Psychologists would know a lot more about this than me, but it was something akin to we're all kind of by when we're born, and then we are socialized into the norm, which is heterosexuality on before, it actually had a degree of sympathy towards homosexual people. But he was still like, Well, last, just like, you know, that's an abnormal response to the fact that you found See your dad or, you know, you've got Penis envy or whatever. Um, but there was sort of from then you originally in the early 20th century, they were doing a lot of stuff like hypnosis to try and cure homosexuality. And then, um, sort of later, that is, things start to become a lot more physical with really quite disturbing. Actually, you know, this is when you start getting like lobotomy zar like chemical castration. If any of you are familiar with the story of Alan Turing, there was, like, a version therapy, which is the classic, what we would all know, um, off like, Well, they would basically make people men particularly right, because although female homosexuality or, um, Sapphic desire has been very much family upon, it's never been treated the same way because women don't matter mist or ically. But for the men, there was a lot of issues, you know, a lot of stigma. They were debating themselves. They were putting them in this Feldene feminine position on until they didn't really horrible things to try and fix it or cure it on. One of the things up until the seventies in Britain was either make guys watch a corn or yeah, you know, images or videos make them think about gay staff and then, like, electric shock them or give them medications that would make them be sick or have don't want, you know, diarrhea. On the whole point is that physically just abused? Um um on the whole point was to try an associate that arousal with negative feelings to try and push him away from him from and not actually happens still reasonably recently in the UK and in the seventies recently, you know, we've all been very much pushing to be nice. So called conversion therapies are just no Okay, in any form, you'll see a lot of the advocacy groups such as God, which on the part off we will call it so called converted therapy, cause the point being that it doesn't actually convert anybody of anything on calling it conversion therapy almost implies that it works. Is that is the concept behind you in the linguistic. So we were You'd often see it called, like so called conversion therapy or SC CT Onda. We've been pushing, trying at med schools in the government, everybody to have a really clear starts on that. Another is a debate, even amongst people who care about this issue on a very pro. Okay, beauty, right about where we draw the line in terms of legalizing or criminalizing it, criminalizing it rather because there's this fear that if we criminalize, like, actually make punishment, then you're going to end up kind of driving vulnerable people even further under the radar. And, you know, there's no question that circle conversion therapy is wrong. But there was a question about Okay, How is the best way to support potential victims? Um, there's a whole kind of issue about consent. Can somebody consent to conversion therapy? You know, because adults Congar Oh, adults can willingly choose toe put themselves under that, but that, you know, the question really is, Why have they been coerced to Who's making them do that? What's the You know, there's never there is always a lot more complicated than that on. So the kind of the bay is about the best way to support potential victims in the UK You know, mostly circle conversion therapies nowadays are around by religious organizations. But you know, certainly us is. The medical profession have had, ah, hand on that for a long time. In terms of trans air or trans identities like that husband, you should see more like interesting to track. I mean, trans people have obviously suffered great harm from both medical professionals and society in general. Um, I'm almost with more media that they've been getting recently a lot of people who kind of want that Wallert beforehand or start to get up in arms about trans rights. Um, because because I'm more aware, I'm just like, I'm sure you've seen these debates about when I Transredes infringe on women's rights because women remain on underrepresented and undervalued partner box or itty Um, no. You know, we generally say you know, transluminal women and should be treated as such. Um should be free to be in women spaces for one of the our image along. Often see, is that, say trans women shouldn't be allowed in women's only shelters on the underlying feeling. There is, ultimately that Trans women are men on. Does Hman have these sort of brutal or abusive tendencies? And now, obviously trans women can be abusive. But I think a lot of the arguments against allowing trans women into these places a felt a respect that actually Transworld Min are significantly more likely to be abused themselves both physically, emotionally and sexually. Statistics are genuinely horrendous. I mean, we're not just talking about the US where ah lot of our information about trans people does tend to come from a social perspective just because of the trump, the American termination of media. But like even in the UK, we have some really horrible numbers off. Actually, you know, like 50% of Trans people have tried to kill themselves like half of the whole population is is an absolute disgrace. And what we know we're failing as medical professional somewhere in there. Um, but in terms of, you know, this debate about whether transplant would be allowed in women's shelters or something. The question that I often come back to people with this like, Well, you know, your assumption is that this person is gonna come into, ah, women's only shelter and start harming people there. But, like, they're not gonna walk in and just randomly start using strangers, right? Like, what's that about? So if you're then concerned that they're gonna go abuse their partner who's fled to a to a shelter Well, actually, that's something that shelters already should be able to deal with, because it's not ours common as with the heterosexual couples. But let's be in nursing. You know, women in same sex relationships do abuse it. Another, that's a you know, that's an unfortunate fact on go If the If the If the lesbian can walk into, ah, you know, a shelter, then then what I can work on the Transform is the question I would raise, too. But that's kind of not the point that I'm trying to get out. And that was in a side. I'll apologize in terms of, you know, Trans, um, medicalization. The support of traumas People from doctors goes back surprisingly far on D that is obviously a minority of doctors, a small proportion of people who are very well known in their field on DPA sublease. We know more about them than we do about people who are supportive of homosexual patients just because of the boundaries that these doctors were pushing of the time. So the example I'll give us there was a German doctor in the 19 thirties who set up this clinic in Berlin that employed and supported and treated trans people on, but was the first place that trans women ever received a gender affirming surgery. If any of you have seen the Danish girl, Lily, l had her surgery at this at this clinic. Um, I don't like in the 19 thirties to be doing, you know, gender affirmation surgery, I think is actually like, you know, there's never 100 years ago. I think that's quite impressive, but this is a mind like this is just a small handful of doctors, you know, This wasn't the whole medical professional board on. Sadly, this clinic was raised by the Nazis when they came to power. Because the Nazis didn't just hate Jews. They hated gays. They hated communists. They hated gypsies. A hated, you know, or all sorts of people on. Yeah, they were not all supportive of this clinic, and it got destroyed, and a lot of their records got destroyed sadly. But some of the people who worked at the clinic then came on and develop their own stuff. So the first hormone therapies to support from its patients were developed in the forties, sort of on the back of that on, but was a very famous British surgeon who her basically originally had been treating hypo Spadea So and then went to well or two on did a lot of work on reconstruction off, um penises and, um, genitalia. Because of his experience in that field and then ended up to after the war ended up taking that and using it to support transmission, which is really cool on. Actually, one of his patients was Michael Dylan, who was a doctor transmittal doctor who worked in the UK on was quite interesting and in the field of Transcultural himself, he sadly was outed as a transplant by I think The Daily Mail on had to flee and ended up becoming Buddhist monk. Awesome line. But, um, you know, they sort of some of the medical staff goes quite far back. And I think although generally I would push against medical izing algae Bt identities, if you're not medicalizing the identity of trans people, which is different if you're after using medicine to support their, uh, you know, physical, physical and mental health through, um, helping them look and feel like the gender that they are on. That's an entirely acceptable thing. Uh, but looking back to the whole conversion therapy debate, there are some people who try to say the gender information therapy is converting straight justice people and to translate empty them is Frankly, little nonsense is far as I'm concerned, but you'll see some really, um, sort of you will see people push back against that kind of thing. If if you pay attention on, then in terms of interest sex people now intersex people can consider themselves in the old DPT Q plus community. But no, everybody does on theirs a bit more of a distinction with this, because being into sex specifically isn't an identity. Now some people do consider themselves intersects as an identity, but, like it is much more define a ble medical like condition where their sex don't like the sexual characteristics. Do no match what we would expect in some way or another. And the you know what counters into sex can sometimes be debated on. You'll end up getting into, you know you'll see different clinics and different cultures have different ideas. But regardless of where the exact line is, we all agree that there is people who go stay in one way or another what we might expect. You know, some people have testies, but have you know XX um, chromosomes, you know, um, on There was obviously a medical place for that. Now there are lots of conditions where it's the, you know, lots of intersex conditions that don't cause any harm to that individual other than having, um, you know and unclear not That's obviously know, brilliant term, um, sex from. But there are other conditions where actually being into sex does affect your physical health in other ways. You know, people who have various other hormone problems that that may need treatment. You know, things that client felt like you need to support these patients in other ways. Um, and that's very aside from what I'm going to talk about, you know, here on I think that, you know, there shouldn't be any question that if somebody who's gonna have heart failure or 12 because of this condition, and that's a medical issue that we need to help them with. But in terms of where you how you support their identity, the gender identity, there was a lot of still debate around that it used to be forced upon people. There was a very questionable man in the 19 fifties in America who basically, I mean almost progressive. First time felt that I gender was an entirely social thing on that it was in no way linked to your sex on, and that you could just be a zombie. You were real good. In a way that was. Everybody said, this is your gender. Then you would have a solid gender identity. And you've never had any issues. Um, on. So hey, basically, Like I said, this press, this baby's Penis looks too small to ever be functional as a Penis when they're in adults, so they operate on them, make like, basically turn. It changed that time your Penis into something, look more like a vulvar and raise. This person has a has a girl on that has caused a lot of trauma to the interest sex community because there was this whole thing where not only the Children were never informed of their, you know, interest sex status. But their parents were kept. A lot of information was hidden from them under this auspice that, you know, for the child to have a, you know, strong, stable gender identity that parents have to be committed to their gender identity. Two. So you've hide information from them so that they didn't have any doubts on. There was a really interesting case of a pair of twins, um, male twins who will get circumcised. One of them. They said it went wrong. and they ended up traumatizing the Penis. And they came to this guy's clinic and he was like, Right, Well, that's never gonna be a proper Penis. So I started giving Basically said, Raise, this child is a girl started giving him hormones. That was what the parents did. So they had one twin that was raised as a mother boy on the other was raised. A girl on originally, like this guy was like, Look at my methods. Look, amazingly, they broke this guy. You know this this child is a girl and feels like a girl, Whatever on then, actually when, um when that person became, I think it's called the John Joan case when that person became like 17 or 18 and found out, like was absolutely destroyed, ended up killing themselves at the age of 29 or something, because off the trauma mental, for my understanding they inflicted upon them by this whole thing on. There's been a lot of interference in the last 100 years in terms of the Internet access identities and trying to make them fit into what we expect of one sex or another. Before that, there's pretty much nothing about intersex people. And that's because they were just considered part of the community in any other way. Um, you know, there was evidence of interest sex people going back thousands of years on it, you know, until we as conditions got our hands on and start considering it on issue, they were perfectly normal part of the community. So in terms of us is doctors, what's what's our place? You know, um, there was originally on organization called the GM A the game Medical alliance in the seventies, as the general rights movement was progressing across the world. I mean, you know, in the UK, they, um they got going together, and I mean, this was a very dangerous time. TOB, Oma sexual. You know, you could lose your job. You could lose all your friends. You know, your families could exercise you like you to be an out gayed doctor. Especially given that weren't such trusted positions. It was very, very difficult and dangerous. I'm not. Unfortunately, the Game Medical Alliance was absolutely decimated in the eighties on do so. Many of their members died from HIV, so it just collapsed. Um, and kind of didn't become a thing for a few years until some of the remnants of the GM A and some other people got together and create glad in 19 94. Um, now we've way. I've got evidence, you know, from our archives I was looking at a couple of weeks ago, I was really quite tragic, actually. Some of the stuff that people were saying and that's, you know, that's not even that long ago. Um, I was still a very difficult, hard time to be a condition. I think things have got significantly better. Um, you know, people can be out working people can be respected at work. I mean, you know, doesn't change their career prospects in the way that it used to, but that there is still issues. You know, we're still finding evidence of homophobia that directly or transphobia directly, but also a lot of like minor things that people wouldn't report but find belittling, find difficult, find challenging in their life, and are still people leaving. They're chosen medical specialties because they don't think that they would be successful or tolerated in there. And, you know, um, as an LGBT person. So there's still a lot of work to go. I'm not sure where you guys are in your stage of training that there was a recent survey out from the BMA and from acid Glad's about GI doctors and then students experiences in in the NHS. And, um, I look forward to kind of see what the results of that are. Does anybody have any questions? Anything. They want to know where when I also want to discuss. I mean, that's very not like there's no other people here. I understand. I'm a cake. Been wracking to say stuff, but, um, look, if you have any questions concerns, you can email name My email address is Kiera Greer. Doctor store cases. They treated my name. No dots at doctor Still. Okay, obviously already current you guys do in joint. Glad because we're supporting. We do events. We do activism. We dont occasion. But you know, you don't have to be a member toe for us to try and provide support on you Also don't have to be LGBT to join. You just have to agree with our aims, which are, you know, just support. Um, how would you be Team doctor's on patients? I'll be in the panel later. So, um, you can always come back to them. Thank you so much for. And day. I'm sorry about the confusion. Started stuff swell. And also sorry. I'm, like, really bugged up. So, like, I can't speak for me. Yeah, but thank you so much for coming to the conference. It was really interesting talk. I definitely learned to up. Mm. Okay, I just Mostly what we put more about, like and the bladder organizations I actually hadn't really like heard. Want to go that way home? Yeah. So, um, we are the only specific organization the represents DBT keep last doctor's dentist. Um, respective students across the UK You know, obviously there are a bunch of little organizations that could support people in similar ways, like, you know, Stone Wall or maybe a local. Then they just trust never like a no DBT trust network. But there isn't anybody any other significant old irritation. You're not in that respect in the country. Um um are we have a lot of different stuff that we do eso as it's like activism. We've got this, um, memorandum of against concert version therapy. One of our committee has been working on a getting us something a thing, Doc. Declaration that universities are signing to say that. You know, this is an absolutely It starts, like there again stung. Think we need to support their LGBT students. Um, so we do education. We do socials. I do a lot of work in this kind of regard. Talking to a med students. I also a lecture to GP trainings about, um, LGBT health. I mean, what one of things that's important to me. Um, is it a lot? A lot of people don't realize that DBT people, as a population, have specific health needs not relating to their sexual health on. But, you know, I will go in and I'll do these talks And actually from May, if people come out of it and say I've actually got more questions about health care for this population than I did when I came in, I almost feel like I've succeeded them because the amount of people who say like they wouldn't have even considered it is a factor. Until I talked to them and it's there's only so much I can say in analogue right and on. It's just trying to make people aware of that. Actually, it does make a big difference. Know, in somebody's allergy Bt status. Um, Andi that they were up thing, you know, things to consider. If you see LGBT patients, you know, risk factors and what not. I think a lot of people maybe underestimate the value of that. But, you know, like, if you're gonna turn around and tell me that people have black African heritage and more likely to have a certain form of CKD, then I don't see why I can't say to you. Well, it's important to know that, you know, um, it has been women are more likely to have, like, obesity and smoking, you know, because these are all important risk factors that, you know, you've got to understand on. Maybe it doesn't make a big difference to that individual patient, but it makes a difference. That population as a whole in your treatment. Great. Thank you. I'll definitely, like check it out. Because we've been worried because I hadn't and much been, uh, prior. Yeah, we've got a women's network. We've got a book club with ago. Uh, we do socials. Hopefully we're trying to make up in leads or something. that the women set Work some point soon. Um, which should be fun. So Yeah. Great. Thank you. I think that it contained Know, but just words small. Interesting. Have so many problems. You know what time they panel is? How much? You know, I was just gonna double track for you to move. I don't like to thank You have to have, uh okay, so call 10 minutes. Wake up, language I